Precursors to a preschool overweight intervention: Exploring the predictors and perceptions of preschool overweight in a low-income, minority, urban community

Date of Completion

January 2007

Keywords

Health Sciences, Nutrition

Degree

Ph.D.

Abstract

Preschool overweight disproportionately affects minority children from low-income families. This research set the foundation for the development of a preschool overweight intervention grounded in a behavior model, targeting minority preschoolers from low-resource families living in urban communities. ^ The first study examined the relationship between low birth weight (LBW), rapid weight gain (RWG), and weight at 24–38 months of age through secondary analyses of two retrospective randomized chart reviews. Almost 18% of preschoolers were overweight between 24–38 months of age with 7% of those children being extremely overweight. Children who experienced RWG during the first year of life were 9.2 times more likely to be overweight and 31.2 times more likely to be extremely overweight at 3 years of age than those who did not experience RWG. Children born LBW were 4.15 times more likely to be underweight at 3 years than those born normal weight. ^ The second study investigated parental perceptions of preschool overweight in a low-income, minority, urban population. Researchers conducted 10 focus groups and 18 follow-up individual interviews with parents of preschool children from Hartford, CT. Parents disagreed with the clinical definition of preschool overweight, expressing distrust in the growth charts. Unlike clinicians who use BMI percentiles to determine overweight, parents identified overweight preschoolers using visual cues and health indicators. Parents were only concerned about weight in those children suffering physical or mental health consequences attributable to excessive weight. ^ Using a survey measuring parental information, motivation, and behavioral skills (IMB) related to child sweetened beverage consumption (SBC) and a parent-reported Home Beverage Inventory, the final study examined factors influencing child SBC. Structural Equation Modeling revealed the IMB model accounted for 14% of the variance of child's SBC. Both Information and Behavioral Skills had a direct effect on SBC. Additionally, Information had an indirect impact on SBC mediated through Behavioral Skills. However, Motivation only had an influence of SBC mediated through Behavioral Skills. ^ Preschool overweight continues to afflict the children of low-income, minority families living in urban areas, including Hartford, CT. This research builds the foundation for preschool overweight nutrition education intervention programs for families from this population. ^

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